scholarly journals A New Proposal: A Digital Flow for the Construction of a Haas-Inspired Rapid Maxillary Expander (HIRME)

Materials ◽  
2020 ◽  
Vol 13 (13) ◽  
pp. 2898
Author(s):  
Mauro Cozzani ◽  
Salima Antonini ◽  
Daniela Lupini ◽  
Davide Decesari ◽  
Fabrizio Anelli ◽  
...  
Keyword(s):  
Mixed Dentition ◽  
Deciduous Teeth ◽  
Maxillary Expansion ◽  
Posterior Crossbite ◽  
Optical Scanner ◽  
Proposal A ◽  
Patient Cooperation ◽  
Optical Impression ◽  
First Moment ◽  
Commercial Expansion

Maxillary expansion is a common orthodontic treatment used for the correction of posterior crossbite resulting from reduced maxillary width. Transverse maxillomandibular discrepancies are a major cause of several malocclusions and may be corrected in different manners; in particular, the rapid maxillary expansion (RME) performed in the early mixed dentition has now become a routine procedure in orthodontic practice. The aim of this study is to propose a procedure that reduces the patient cooperation as well as the lab work required in preparing a customized Haas-inspired rapid maxillary expander (HIRME) that can be anchored to deciduous teeth and can be utilized in mixed dentition with tubes on the molars and hooks and brackets on the canines. This article thus presents an expander that is completely digitally developed, from the first moment of taking the impression with an optical scanner to the final solidification phase by the use of a 3D printer. This digital flow takes place in a CAD environment and it starts with the creation of the appliance on the optical impression; this design is then exported as an stl extension and is sent to the print service to obtain a solid model of the device through a laser sintering process. This “rough” device goes through a post-processing procedure; finally, a commercial expansion screw is laser-welded. This expander has all the advantages of a cast-metal Haas-type RME that rests on deciduous teeth; moreover, it has the characteristic of being developed with a completely digitized and individualized process, for the mouth of the young patient, as well as being made completely of cobalt-chrome, thus ensuring greater adaptability and stability in the patient’s mouth.

Evaluation of Changes in Muscle Thickness, Bite Force and Facial Asymmetry during Early Treatment of Functional Posterior Crossbite

2010 ◽  
Vol 34 (4) ◽  
pp. 369-374 ◽  
Author(s):  
Paula Midori Castelo ◽  
Maria Beatriz Duarte Gavião ◽  
Luciano José Pereira ◽  
Leonardo Rigoldi Bonjardim
Keyword(s):  
Early Treatment ◽  
Repeated Measures ◽  
Muscle Thickness ◽  
Facial Asymmetry ◽  
Bite Force ◽  
Mixed Dentition ◽  
Stepwise Multiple Regression ◽  
Masticatory Muscle ◽  
Maxillary Expansion ◽  
Posterior Crossbite

Objective: To determine morphological and functional effects on masticatory system of early treatment of functional posterior crossbite in young children. Study design: 23 children were divided into two groups:deciduous (DecG, n=11) and early mixed dentition (MixG, n=12), which received slow maxillary expansion. Maximal bite force, ultrasonographic masticatory muscle thickness and facial asymmetry were evaluated in three stages: before the start of treatment (s1), after three months of retention (s2), and after three months of observation (s3). The results were analyzed by Mann-Whitney U-test, correlation test, repeated measures ANOVA and backward stepwise multiple regression. Results. Bite force and temporalis thickness increased from s1 to s2 and s3 in both groups (p<0.05). Body mass index (BMI) increased significantly from s1 to s3 only in the MixG, but the masseter thickness did not differ among the stages. The correlation between the angle of the eye and the angle of the mouth in relation to the mid-sagital plane increased from s1 to s3. Masticatory muscle thickness contributed significantly to bite force magnitude in all stages, whereas age and BMI showed no significant contribution to its variation. Conclusion: Bite force and temporalis muscle thickness increased significantly in children after early treatment of functional crossbite.

scholarly journals Early timely orthodontic treatment: Treatment of unerupted maxillary laterals

2021 ◽  
Vol 11 ◽  
pp. 4-13
Author(s):  
Peter Ngan ◽  
Mohamad Sarraj ◽  
Ghaddy AlSaty
Keyword(s):  
Early Intervention ◽  
Orthodontic Treatment ◽  
Case Reports ◽  
Young Patients ◽  
Mixed Dentition ◽  
Maxillary Expansion ◽  
Orthopedic Treatment ◽  
Maxillary Protraction ◽  
Posterior Crossbite ◽  
Timely Treatment

There is no universal agreement as to which type of orthodontic or orthopedic treatment deserves early intervention. In addition, there is a need for more information as to which treatments are the most effective and less costly if they are initiated timely in the mixed dentition. Early timely treatment may benefit young patients with a maxillary transverse deficiency with or without a posterior crossbite that requires maxillary expansion. It may also be indicated in children with anteroposterior jaw discrepancy that requires chin cup or maxillary protraction. In this paper, the authors will focus on early maxillary expansion to facilitate the eruption of maxillary laterals. In specific, the authors will present a contemporary protocol using a bonded maxillary expander as anchorage for treatment of unerupted maxillary laterals. The use of this protocol was illustrated with two case reports to enable clinicians to routinely achieve a beautiful smile on a young patient by timely alignment of the maxillary incisors.

scholarly journals Dimensional changes in the palate associated with slow maxillary expansion for early treatment of posterior crossbite

2018 ◽  
Vol 88 (4) ◽  
pp. 390-396 ◽  
Author(s):  
Abdulkadir Bukhari ◽  
David Kennedy ◽  
Alan Hannam ◽  
Jolanta Aleksejūnienė ◽  
Edwin Yen
Keyword(s):  
Surface Area ◽  
Mixed Dentition ◽  
Maxillary Expansion ◽  
Dimensional Changes ◽  
Palatal Expansion ◽  
Posterior Crossbite ◽  
Treated Sample ◽  
Student’S T ◽  
Functional Shift ◽  
Area And Volume

ABSTRACT Objectives: To compare palatal symmetry, dimensions, and molar angulations following early mixed-dentition slow maxillary expansion with parameters in normal controls. Materials and Methods: A total of 30 patients treated with a Haas-type expander for unilateral posterior crossbite with functional shift were compared with 30 controls matched for dental age, gender, and molar relationship. Records were taken before (T1) and after expansion (T2). Palatal width, surface area, volume, and molar angulations were measured on digitized models. Surface area and volume were split in half then divided into anterior, middle, and posterior segments to measure symmetry. Student's t-test was used to assess group differences. Results: Mean intercanine width increased 4.65 mm, and intermolar width increased 4.76 mm. The treated mean surface area increased 127.05 mm2 compared with 10.35 mm2 in controls. The treated palatal volume increased 927.55 mm3 compared with 159.89 mm3 for controls. At T1, the controls showed significant differences in surface area and volume between the anterior palatal segments. At T2, this difference occurred in surface area of middle palatal segments of the treated sample. First permanent molars showed an increased buccal and distal inclination after treatment, opposite to controls. The increase in buccal inclination was greater on the crossbite side. Conclusions: The Haas-type expander results in similar expansion across the canines and first molars. A palate that is symmetrical before expansion may become asymmetric after expansion but only in the middle segment. Changes in individual molar angulation following palatal expansion can be measured without radiation imaging.

Effects of Combined Rapid Maxillary Expansion and Facemask Therapy on the Mandibular Dental Arch in Mixed Dentition

2020 ◽  
Vol 44 (6) ◽  
pp. 459-463
Author(s):  
Fatma Deniz Uzuner ◽  
Tuba Tortop ◽  
Şenol Gülşen ◽  
Selin Kale Varlık
Keyword(s):  
Combined Therapy ◽  
Face Mask ◽  
Rapid Maxillary Expansion ◽  
Mixed Dentition ◽  
Dental Arch ◽  
Maxillary Expansion ◽  
Mandibular Incisor ◽  
Skeletal Class ◽  
Posterior Crossbite ◽  
Dental Model

Objective: The aim of this study was to evaluate changes in the mandibular dental arch and incisor alignment induced by combined bonded Rapid Maxillary Expansion (RME) and Face Mask (FM) therapy in the mixed dentition stage in which leeway space was used throughout the treatment. Study Design: This retrospective study evaluates pretreatment (T0) and posttreatment (T1) cephalometric radiographs and orthodontic models of 25 patients (mean age: 10.75±2.64), in mixed dentition, having skeletal Class 3 anomaly (ANB<0) with maxillary retrognatism (SNA=77.2±0.68) and bilateral posterior crossbite treated with bonded Hyrax RME-FM. Mean treatment duration was 10.4 months. Dental model measurements were performed using the 3Shape OrthoAnalyzerTM 2013-1 program. Changes in the mandibular incisor and first molar positions were determined on cephalometric radiographs. Statistical evaluation was done with a paired t-test. Results: A significant increase of 1.2 mm was found in intermolar width (p<0.001) in the mandibular dental arch. There was a significant decrease (1.4 mm) (p<0.001) in arch depth and an increase in arch length discrepancy (1.7mm)(p<0.01). There was a significant increase (0.8mm) (p<0.05) in the incisors’ irregularity score (LII). IMPA showed a significant decrease (p<0.05). Conclusion: Clinicians should be aware that mandibular crowding tends to increase during this type of combined therapy.

scholarly journals Early Orthodontic Treatments of Unilateral Posterior Crossbite: A Systematic Review

2020 ◽  
Vol 10 (1) ◽  
pp. 33
Author(s):  
Francesco Caroccia ◽  
Francesco Moscagiuri ◽  
Luigi Falconio ◽  
Felice Festa ◽  
Michele D’Attilio
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Scientific Evidence ◽  
Treatment Strategies ◽  
Mixed Dentition ◽  
Control Group ◽  
Maxillary Expansion ◽  
Posterior Crossbite ◽  
Quad Helix

We aimed to report an update of the systematic review by Petrén et al. (2003). The objective was to evaluate how orthodontic treatments can affect unilateral posterior crossbite (UPXB) in primary and early mixed dentition. Several databases were consulted, and articles published between January 2002 and March 2020 were selected. This review examines the following studies: randomized clinical trials, prospective and retrospective studies with concurrent untreated or normal control groups, and clinical trials comparing at least two treatment strategies. Among the 1581 articles retrieved from the searches, 11 studies were included. Quad-helix (QH) and expansion plate (EP) appliances were compared in three studies. One study compared rapid maxillary expansion (RME) treatment anchored on primary dentition otherwise on permanent molars. One study compared RME and a modified RME with arms extended until deciduous canine and EP. Four studies evaluated the effects of expansion appliances compared with a control group. Compared with the previous review, the quality of the included studies is higher. However, heterogeneity of treatments, different strategies in measurements, lack of a similar follow-up length, and absence of a cost-effectiveness analysis preclude the possibility of providing reliable scientific evidence on the most effective UPXB treatment in primary and early mixed dentition.

Avaliação da prevalência da perda precoce de molares decíduos na dentição mista

2020 ◽  
Vol 13 (52) ◽  
pp. 102-106
Author(s):  
Ana de Lourdes Sá de Lira ◽  
Cassius Wander Coelho Martins ◽  
Luis Paulo da Silva Dias ◽  
Tito Cacau Sousa Santos
Keyword(s):  
Mixed Dentition ◽  
Deciduous Teeth ◽  
Chi Square ◽  
Space Maintainer ◽  
Chi Square Test ◽  
Fixed Space ◽  
Deciduous Molar ◽  
One Year ◽  
Deciduous Molars ◽  
Lower Arch

Objective: To assess primary molars early loss in mixed dentition prevalence. Method: A study was carried out in children aged 6 to 12 years. Deciduous molar loss was considered early when it occurred before Nolla stage 6 (full formed crown) of the permanent successor or one year before its physiological exfoliation. Periapical radiographs were obtained to verify the presence of the permanent successor and the level of root formation, as well as the need for placement of fixed space maintainer lingual arch or Nance button. For the study of frequency distribution of early dental loss in relation to gender and dentition, we used the Chi-square test of 5% probability level and the non-parametric Mann-Whitney test for adequate statistical analysis. Results: Of the 315 children examined, 159 (50.47%) were male and 156 (49.52%) were female. Only 25 (7.9%) presented multiple dental losses in the posterior region, 19 in the lower arch and 6 in the upper arch. In the inferior one there was predominance of first and second deciduous molars loss. There was no difference in the association between genders and the occurrence of multiple dental losses (χ² (1) = 0.03, p>0.05). Conclusion: The prevalence of deciduous teeth premature loss was of 7.9% and the most affected teeth were the first and second molars in the lower arch. Lingual arch space holders were installed in 6 children, who will remain with it until the permanent successors erupt into the oral cavity.

scholarly journals Condylar Changes in Children with Posterior Crossbite after Maxillary Expansion: Tridimensional Evaluation

Children ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. 38
Author(s):  
Rosamaria Fastuca ◽  
Helga Turiaco ◽  
Fausto Assandri ◽  
Piero A. Zecca ◽  
Luca Levrini ◽  
...  
Keyword(s):  
Rapid Maxillary Expansion ◽  
3D Analysis ◽  
Maxillary Expansion ◽  
3D Slicer ◽  
Palatal Expansion ◽  
Posterior Crossbite ◽  
Rapid Palatal Expansion ◽  
Before And After ◽  
Condylar Position ◽  
Caucasian Patients

(1) Background: To investigate condylar position in subjects with functional posterior crossbite comparing findings before and after rapid maxillary expansion (RME) treatment through 3D analysis; (2) Methods: Thirty-two Caucasian patients (14 males, mean age 8 y 8 m ± 1 y 2 m; 18 females mean age 8 y 2 m ± 1 y 4 m) with functional posterior crossbite (FPXB) diagnosis underwent rapid palatal expansion with a Haas appliance banded on second deciduous upper molars. Patients’ underwent CBCT scans before rapid palatal expansion (T0) and after 12 months (T1). The images were processed through 3D slicer software; (3) Results: The condylar position changes between T1 and T0 among the crossbite and non-crossbite sides were not statistically significant, except for the transversal axis. At T1, the condyles moved forward (y axis) and laterally (x axis), they also moved downward (z axis) but not significantly; (4) Conclusions: Condilar position in growing patients with functional posterior crossbite did not change significantly after rapid maxillary expansion.

scholarly journals CBCT Comparison of Dentoskeletal Effects of Haas-Type and Hyrax-Type Expanders Using Deciduous Teeth as Anchorage: A Randomized Clinical Trial

2021 ◽  
Vol 11 (15) ◽  
pp. 7110
Author(s):  
Marco Serafin ◽  
Luca Esposito ◽  
Viviana Conti ◽  
Rosamaria Fastuca ◽  
Manuel Lagravère ◽  
...  
Keyword(s):  
Primary Teeth ◽  
Statistical Significance ◽  
Three Dimensional ◽  
T Test ◽  
Mixed Dentition ◽  
Deciduous Teeth ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion ◽  
Clinical Changes ◽  
Skeletal Expansion

The aim of this study was to compare the three-dimensional dentoskeletal effects of Haas-type and Hyrax-type expanders using primary teeth as anchorage for rapid palatal expansion (RPE). Thirty-four subjects in mixed dentition were divided according to their expander’s type: Hyrax (n = 16; 6F, 10M; mean age 8 ± 3 years) or Haas (n = 18; 14F, 4M; mean age 8 ± 2 years). Each patient underwent CBCTs before (T0) and after RPE (T1). Dentoskeletal changes were collected. A paired sample t-test and independent t-test were used to compare each variable within the same group and between groups, respectively, with a 5% significance. The Hyrax group showed an increase in all dentoskeletal parameters; skeletal expansion was significantly increased anteriorly (1.76 mm) and posteriorly (1.93 mm). The greatest dental expansion was observed in the anchorage unit (6.47 mm), about twice as much as permanent molars (3.42 mm). The same statistical significance of Haas group measurements was observed; anteriorly skeletal expansion (2.97 mm) was greater than posteriorly (1.93 mm) and dental expansion was greater on anchored teeth (6.80 mm) than non-anchored teeth (4.57 mm). No statistical significance was observed between Hyrax and Hass groups. CBCT analysis showed that, in RPE, the dental expansion was greater than skeletal expansion. No significant or clinical changes were observed between Hyrax and Haas appliances anchored to primary teeth.

scholarly journals Early management of class II division 2 malocclusion. Literature review

2017 ◽  
Vol 23 (2) ◽  
Author(s):  
Carolina Rodríguez-Manjarrés ◽  
Margarita-Rosa Padilla-Tello
Keyword(s):  
Treatment Options ◽  
Relevant Information ◽  
Class Ii ◽  
Mixed Dentition ◽  
Mandibular Advancement ◽  
Maxillary Expansion ◽  
Early Management ◽  
Mandibular Retrognathism ◽  
Dental Crowding ◽  
Division 2

This paper presents the most relevant information about the class II division 2 malocclusion (II / 2) described in the literature and different treatment options based on orthopedics. Class II malocclusion is characterized by mandibular retrognathism and / or prognathic maxillary which could affect the molar relationship and considering the dental component is subdivided into Type 1, characterized by vestibular inclination of all upper incisors and Type 2 with upper central incisors retroclined and vestibularized lateral incisors. It presents multifactorial etiology. As reported by the literature, the incidence of malocclusion Class II / 2 ranges from 3-12%. It is characterized by different vertical, transverse, facial, skeletal and dental features that differentiate it from other malocclusions, and thus make decisions on time. Therefore, early treatment of this type of malocclusion, can reduce the possibility of surgery, minimizec the severity of the alteration in stomatological system functions and improve the overall appearance of the patient. The goals of treatment are directed transversely performing maxillary expansion to allow correction in alteration of the axial inclination of the upper incisors and solve dental crowding, leading to a malocclusion class II / 1, for further mandibular advancement. Keywords: Malocclusion, Class II Division 2, mixed dentition, functional orthopedics of the jaws.

scholarly journals Oral conditions of pediatric patients with Williams-Beuren syndrome: two case reports

2019 ◽  
Vol 22 (2) ◽  
pp. 281-288
Author(s):  
Flávia Silva Pires ◽  
Viviane Andrade Cancio Paula ◽  
Khawana Faker ◽  
Natalia Di Lanaro ◽  
Raissa Christiane O de Carvalho ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Case Report ◽  
Congenital Heart ◽  
Prophylactic Antibiotic ◽  
Pediatric Dentistry ◽  
Mixed Dentition ◽  
Psychomotor Development ◽  
Deciduous Teeth ◽  
Oral Conditions

Objective: The objective of this paper was to describe the oral conditions of two children accompanied by their mothers who reported to the Department of Pediatric Dentistry of Fluminense Federal University with Williams-Beuren syndrome (WBS). Case report: The 9-year-old female patient had a family and medical history significant for placental abruption, caesarean section, delayed psychomotor development, learning disabilities, tendency to selfdistract and congenital heart disease. In contrast, the 7-year-old male patient had a normal birth and no gestational intercurrences. Discussion: Clinically, the female presented with mixed dentition, crowding in the maxillary and mandibular arches, prolonged retention of deciduous teeth, anterior and posterior cross-bite and Angle Class I malocclusion, while the male had mixed dentition and retarded psychomotor development. Due to the patients having congenital heart disease, a prophylactic antibiotic regimen was prescribed prior to the dental procedures in both of them. Conclusion: These patients had been followed up for 2 years and this case report underscores the importance of early dental evaluation and counselling for parents of WBS patients.KeywordsWilliams Beuren syndrome; Oral manifestations; Child.

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